Effectiveness of Various Final Irrigation Techniques on Sealer Penetration in Curved Roots: A Confocal Laser Scanning Microscopy Study

Abstract

Objective. To compare the efficacy of various techniques used for final irrigation on sealer penetration in the apical one-third of curved root canals. Material and Methods. Sixty-five freshly extracted maxillary first molar teeth with mesiobuccal roots having more than 20° of root curvature were used. The root canals were instrumented and randomly divided into four experimental groups and one control group. In the 4 experimental groups, 3 ml of 17% EDTA followed by 3 ml of 5.25% NaOCl was delivered with the use of the following protocols: Group 1: manual dynamic activation (MDA), Group 2: sonic irrigation (SI), Group 3: passive ultrasonic irrigation (PUI), and Group 4: conventional needle irrigation (CI). All teeth were obturated with gutta-percha and AH Plus sealer labeled with fluorescent dye. Transverse sections at 2 mm and 4 mm distance from the root apex were examined with the aid of confocal laser scanning microscopy. Total percentage (%) and maximum depth (μm) of sealer penetration were measured. Results. All the experimental groups exhibited significantly higher penetration rates than the control group at both sections (p<0.05). However, no significant differences were found in the penetration depth and percentage among the four experimental groups evaluated at both sections (p>0.05). Conclusion. PUI, SI, and MDA did not significantly improve sealer penetration in the apical portion of curved root canals when compared to conventional needle irrigation.

The effect of nanoparticle addition to a bioceramic sealer on its intra-tubular penetration.

“…These reasons could prove our results and hence confirm that PUI as a final irrigation protocol is superior over CI concerning increase sealer intra-tubular penetration. The present results are in agreement with Machado et al (15) ; Akcay et al (26) ; De Souza et al (29) ; Gu et al (30) ; Aksel et al (31) ; Zand et al (32) , but on contrast Yilmaz et al (33) as curved root canals were used which is a challenging case to deliver the irrigation to the apical portion regardless of the irrigation technique.…”

Effect of ultrasonic agitation on the penetration depth of different root canal sealers

“…15 Agitation of irrigants enhances the sealing properties of filling material to attain impervious seal interface among core material and root canal wall. 16 In the present study, 17% EDTA was used as it owns low surface tension and would enlarge the porosity in endodontic treatment, eliminates inorganic part of smear layer, opens the dentinal tubules and also lateral canals. 14 In first subgroup-ultrasonic agitation of sodium hypochlorite was performed.…”

Comparison of sealer penetration of sonic activation versus conventional needle irrigation: a systematic review and meta-analysis of randomized controlled trials

“…Twenty-five studies met the conditions for full-text review after being subjected to title and abstract screening, of which 9 directly made comparisons between CNI and SI under the previously mentioned criteria, making them eligible for inclusion (Table 2 ). Only 8 of those studies provided a meta-analysis with enough quantitative data [ 10 , 17 , 24 – 29 ]. Table 3 provides a detailed explanation of why the 16 publications were rejected and excluded from the full-text review.…”